# Neurobiology of Affective Instability in Veterans at Low and High Risk for Suicide

> **NIH VA I01** · JAMES J PETERS VA  MEDICAL CENTER · 2020 · —

## Abstract

Recent work demonstrates that veterans exhibit higher suicide risk compared with the general U.S.
population. Despite progress in understanding risk factors for suicidal behavior, the pathogenesis is poorly
understood, including alterations in the neural circuitry underlying affective instability (AI) associated with
suicidal behavior. AI is a trait that cuts across multiple psychiatric disorders in a dimensional manner. Two core
components of AI are emotional reactivity and regulation. In addition to examining brain activity and functional
connectivity in key neural circuitry underlying these two components of AI in veterans at low and high risk for
suicide, this project examines affective startle modulation, a translational, psychophysiological measure
mediated by the amygdala that provides a reliable, low-cost, nonverbal metric of AI components. Progress in
the prevention and prediction of suicidal behavior would be facilitated by the identification of quantitative
measures of AI-related neural activity/connectivity and/or affective startle modulation in response to validated
unpleasant pictures and may serve as dimensional psychophysiological endophenotypes of risk for suicide.
Additionally, we will examine three reliable self-report measures of AI (measuring lability, intensity, and
emotion regulation) which may serve as a dimensional phenotype of suicidal behavior. Examining this
combination of neural circuits, physiology, and behavior in veterans at low (non-suicidal psychiatric controls)
and high risk (suicidal ideators, suicide attempters) for suicide, as well as healthy controls, holds great promise
for understanding the pathogenesis of suicidal behavior, and identifying targets that may ultimately provide
novel treatment intervention to reverse such pathogenic processes.
 The proposed longitudinal study will focus on AI as a critical dimension that is directly associated with risk
for suicide and identify the neural-circuitry disturbances that underlie emotion processing abnormalities in
veterans at low and high risk for suicide. To do so, we will characterize a sample of 144 veterans, 36 in each of
the four groups. All participants will receive rigorous diagnostic and clinical assessments (including several
well-validated measures of AI and suicide risk), and undergo 3T functional MRI and affective startle modulation
measurement while they perform passive emotion-processing/reactivity and active emotion-regulation tasks. At
6-month follow-up, all participants will repeat the startle assessment in order to examine test-retest reliability.
Clinical assessment follow-up will be done at 6- and 12-months in the three patient groups. The project aims to
identify behavioral, neurobiological, and psychophysiological features underlying suicidal behavior in veterans
and determine whether baseline psychophysiological measures predict suicidal behavior at 12-month follow-
up. Impact: Our prospective, multi-modal design promises to help uncover t...

## Key facts

- **NIH application ID:** 9892959
- **Project number:** 5I01CX001451-04
- **Recipient organization:** JAMES J PETERS VA  MEDICAL CENTER
- **Principal Investigator:** ERIN A. HAZLETT
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9892959

## Citation

> US National Institutes of Health, RePORTER application 9892959, Neurobiology of Affective Instability in Veterans at Low and High Risk for Suicide (5I01CX001451-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9892959. Licensed CC0.

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